This proposal is for a 5 year research career development plan for Kristina Tarczy-Hornoch, MD, DPhil, to support her transition from a laboratory research background toward an independent patient-oriented research career in pediatric ophthalmology. The development plan consists of (1) structured training: coursework in epidemiology, biostatistics and public health leading to an MPH degree, courses and seminars in research ethics and career development, seminars in ophthalmology and preventive medicine, and practical exposure to clinical research through the research activities of mentors and consultants; (2) mentored clinical research. Her mentoring committee consists of Rohit Varma, MD, MPH, Stanley Azen, PhD, and Mark Borchert, MD, with consultation support from Joseph Miller, MD, MPH and Rowan Candy, MCOptom, PhD. The mentored research study will address a long-standing controversy over the value of early spectacle treatment for young children with hypermetropia, to prevent strabismus and amblyopia. The aims are to recruit 100 children 6-24 months of age with isolated hypermetropia, and conduct a randomized, controlled trial of spectacle treatment, describing the incidence of strabismus/amblyopia by age 3.5 years, as well as visual acuity outcomes, optic disc size, emmetropization, and the prognostic value of accommodative lag. The University of Southern California (USC) strongly supports Dr. Tarczy-Hornoch, and the environment at USC and Childrens Hospital Los Angeles is well-suited to her career development plan. The proposal would lead to (1) her establishment as an independent clinical investigator, and (2) completion of a study addressing a question with important public health implications, likely leading to a large multi-site randomized clinical trial under the auspices of the Pediatric Eye Disease Investigator Group. [unreadable] [unreadable]